137,800 in Miss. fall in insurance 'coverage gap'

They're currently uninsured. They earn too much to enroll in Medicaid but too little to qualify for government subsidies that would reduce their cost of buying private health insurance.

The number represents 37 percent of uninsured Mississippi adults who are younger than 65. Mississippi is one of the poorest states in the nation and it has the highest percentage of residents in the coverage gap.

"Most of these people have very limited coverage options and are likely to remain uninsured," said the study released Wednesday by the Kaiser Family Foundation, a nonpartisan group that has been examining the effect of the health overhaul that President Barack Obama signed into law in 2010.

A family of three can earn no more than about $5,600 to qualify for Medicaid in Mississippi. So, the coverage gap for a family of three would be for those earning more than $5,600 but less than $19,530, which is 100 percent of the federal poverty level for that size family.

"People in the coverage gap are likely to face barriers to needed health services or, if they do require medical care, potentially serious financial consequences," the Kaiser Family Foundation report said.

Under the health overhaul law, federal subsidies are available for people to purchase health insurance from private companies on government-run exchanges, or online marketplaces. The subsidies are for people who earn between 100 percent and 400 percent of the federal poverty level -- $19,530 to $78,120 for a family of three.

The health overhaul law originally would have made states expand Medicaid to people earning up to 138 percent of the federal poverty level. The U.S. Supreme Court upheld most of the law in 2012 but ruled that Medicaid expansion is optional.

Mississippi is one of the 26 states that have, so far, rejected Medicaid expansion. Republican Gov. Phil Bryant and leaders of the Republican-controlled Legislature say Mississippi can't afford to put more people on the federal-state health insurance program for the needy, even with the federal government paying most of the tab.

Republican Dean Kirby of Pearl, chairman of the Senate Public Health Committee, said Wednesday that even without expansion, Mississippi's Medicaid program is requesting a 17 percent budget increase for the state fiscal year that starts next July 1. He said with expansion, the state could face millions of dollars in administrative costs.

"If we had expansion, I don't know that anyone really knows how much it is going to cost," Kirby said.

Democrats in the Legislature have been pushing for Medicaid expansion, saying Mississippi is leaving billions of federal dollars untouched and is ignoring financial problems that uninsured residents face.

"It makes no sense at all that we are prohibiting people in Mississippi from getting Medicaid coverage that is paid 100 cents on the dollar by the federal government, while their counterparts in other states are receiving the benefits," the vice chairman of the Senate Public Health committee, Democrat Hob Bryan of Amory, said Wednesday.

About 640,000 of Mississippi's nearly 3 million residents are on Medicaid now, and expansion would have added roughly 300,000.

For a family of three, 138 percent of the federal poverty level is $26,950. Mississippi's Medicaid program does not cover many childless, able-bodied adults, regardless how low their income is.

The Kaiser Family Foundation numbers for the coverage gap don't include legal immigrants who have been in the U.S. less than five years or any people who entered the country illegally, regardless of how long they've been in the country.